Home Health – Start enrolling your service providers now for electronic visit verification (EVV)

Washington State Health Care Authority sent this bulletin at 04/21/2023 03:43 PM PDT

April 21, 2023

Apple Health (Medicaid) Provider Alert

Attention Home Health Providers

What is changing?

Beginning with dates of service on and after January 1, 2024, all home health servicing providers are required to have an electronic visit verification (EVV) method in place or their claims will be denied by the Health Care Authority (HCA) or the managed care organization (MCO) under a mandate included in the 21^st Century Cures Act. The Centers for Medicare & Medicaid Services (CMS) extended the deadline for requiring EVV to January 1, 2024, for the State of Washington.

How does this affect my billing?

Additional data elements will be required on home health claims. This is for any claim submitted through an 837 or the ProviderOne portal.

New and existing required data elements:

Type of service performed (existing)
Client receiving the service (existing)
Date of service (existing)
Location of service delivery (new)
Individual providing the service (new)
Time the service begins and ends (new)

What do I need to do now?

Enroll your servicing providers now! To facilitate the submission of the EVV home health care services data, your organization should begin enrolling all your home health servicing providers at the individual level now.

Click on the brown box below.

Enroll as a health care professional practicing under a group or facility

When will ProviderOne be ready to accept the additional required data?

On July 1, 2023, HCA will have the ProviderOne system ready to begin accepting the additional data. If these data elements are not included on home health claims with a date of service on or after January 1, 2024, the claim will be denied.

To be paid, providers will be required to correct the claim and resubmit.

Washington Administrative Code (WAC) and Billing Guide Updates

HCA is currently reviewing the associated WACs in Title 182 to update the rules. HCA is also revising the Home Health Services Billing Guide to reflect any necessary changes.

For more information:

See HCA’s Home Health Care Services – Electronic Visit Verification web page.

See also Medicaid.Gov website, Medicaid Electronic Visit Verification.

Contact HCA EVV Home Health with any questions.

About the Health Care Authority (HCA)

The Washington State Health Care Authority (HCA) is committed to whole-person care, integrating physical health and behavioral health services for better results and healthier residents.

HCA purchases health care for more than 2.5 million Washington residents through Apple Health (Medicaid), the Public Employees Benefits Board (PEBB) Program, the School Employees Benefits Board (SEBB) Program, and the COFA Islander Health Care Program. As the largest health care purchaser in the state, we lead the effort to transform health care, helping ensure Washington residents have access to better health and better care at a lower cost.

Please do not reply directly to this message. For more information, visit the HCA website, where you'll also find contact information.

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The Washington State Health Care Authority (HCA) complies with all applicable federal and Washington state civil rights laws and is committed to providing equal access to our services. Visit HCA’s website to view complete nondiscrimination statements.